NPIMap

Individual provider Active NPI

Elias N Moukarzel, M.D.

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • El Centro, CA
National Provider Identifier
1205912847
Registry record updated Nov 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
C50303 Issued in CA
Practice address
2109 West Ross Ave
El Centro, CA 92243-3685
Phone
(760) 352-4103
Fax
(760) 545-0258
NPI assigned
Oct 27, 2006
Last updated
Nov 2, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X C50303 CA Primary

Addresses

Primary practice location

2109 West Ross Ave
El Centro, CA 92243-3685

Mailing address

1296 Westwind Dr
El Centro, CA 92243-4368
Phone (760) 337-2928

Other identifiers 2

IdentifierTypeStateIssuer
W13536OtherCAGROUP PTAN
00C503030MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050207000540 CA Practitioner - Obstetrics/GynecologyPractitioner - Urology 4880645910 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/GynecologyAlso: Urology
Education
State University of New York at Stony Brook, School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

125 S 5TH St
Brawley, CA 92227-2408
Phone (760) 344-8100

2109 Ross Ave
El Centro, CA 92243-3685
Phone (760) 352-4103

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial Valley Womens Clinic Obstetrics & Gynecology PastSince Jan 1, 2002 Accepting new patients
El Centro Regional Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: elias.moukarzel@ivfcmg.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Imperial Valley Family Care Medical Group a P CBrawley, CA, CCN 058984 Rural health clinic 5% Or Greater Direct Ownership Interest (11.12%) Aug 1, 2015

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1205912847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1296 WESTWIND DR",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922434368",
            "telephone_number": "760-337-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2109 WEST ROSS AVE",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922433685",
            "telephone_number": "760-352-4103",
            "fax_number": "760-545-0258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUKARZEL",
        "first_name": "ELIAS",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "CA",
            "license": "C50303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "W13536",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C503030",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

Verify at the official NPI Registry.